V Raveenthiran1. 1. Department of Surgery, Veer Surendra Sai Medical College, Sambalpur, Orissa, India. venkatsankar@yahoo.com
Abstract
BACKGROUND: Diagnostic difficulties are common in sigmoid volvulus. This diagnostic delay contributes to high morbidity and mortality. AIM: This paper recognises visible or palpable emptiness of the left iliac fossa as a new clinical sign of sigmoid volvulus. Predictive accuracy of the sign was assessed in this study. METHODS: 519 patients with acute abdomen of non-traumatic origin were prospectively studied. RESULTS: The new sign was present in 24 out of 86 patients (28%) with sigmoid volvulus. It was absent in all those who did not have sigmoid volvulus. The positive predictive value of the sign was 100%. CONCLUSION: Emptiness of the left iliac fossa is a valuable diagnostic adjunct. Positive sign is pathognomonic of sigmoid volvulus. Nevertheless, a negative sign warrants further investigations.
BACKGROUND: Diagnostic difficulties are common in sigmoid volvulus. This diagnostic delay contributes to high morbidity and mortality. AIM: This paper recognises visible or palpable emptiness of the left iliac fossa as a new clinical sign of sigmoid volvulus. Predictive accuracy of the sign was assessed in this study. METHODS: 519 patients with acute abdomen of non-traumatic origin were prospectively studied. RESULTS: The new sign was present in 24 out of 86 patients (28%) with sigmoid volvulus. It was absent in all those who did not have sigmoid volvulus. The positive predictive value of the sign was 100%. CONCLUSION: Emptiness of the left iliac fossa is a valuable diagnostic adjunct. Positive sign is pathognomonic of sigmoid volvulus. Nevertheless, a negative sign warrants further investigations.
Authors: Hussein A Heis; Kamal E Bani-Hani; Daher K Rabadi; Mwaffaq A Elheis; Bayan K Bani-Hani; Tagleb S Mazahreh; Ziyad A Bataineh; Nabeil A Al-Zoubi; Mohammed S Obeidallah Journal: World J Surg Date: 2008-03 Impact factor: 3.352